PracticeQuestions

1.OSHAallowsunglovedphlebotomyonlyif:
a.Theexperiencedphlebotomistworkinginavolunteerblooddonorcenteragrees.
b.Thephlebotomist'sskinisintactandthepatientiscooperative.
c.Bothaandb
d.Thepatientisaninfant.
2.Thehospitaldepartmentthatstudiesalcohol,drugs,poisons,andheavymetalsis:
a.Serology/Immunology
b.Toxicology
c.Cytology
d.Endocrinology
3.Ahemoglobinelectrophoresisresultofadulthemoglobin(HbA)orHbA2meansthepatient
has:
a.Sicklecellanemia
b.Fetalhemoglobin
c.Normalhemoglobin
d.Hemolyticanemia
4.USlawoverridesthepatient'srighttoconfidentialityif:
a.Thepatienthasasexuallytransmitteddiseaseortuberculosis(TB)
b.Thecaregiverislikelytobeinfected
c.AuthoritiessuspectchildabuseorneglectunderCAPTA
d.Alloftheabove
5.Therecallrateisalsoknownasthe:
a.Sensitivity
b.Specificity
c.Aliquot
d.Circadianrhythm
AnswerKey
1.C:Bothaandb.TheUSOccupationalSafetyandHealthAdministration(OSHA)setsthe
standardsforproperhandwashing,wearinggloves,baggingspecimensinbiohazardbags,and

disposingofneedlesandlancetsinasharpssafecontainer.Visithttp://www.osha.govregularlyto
findupdates.OSHArequiresphlebotomiststoglovebeforeeveryvenipunctureaspartofstandard
(universal)precautionsforbloodbornepathogens.Onlyinavolunteerblooddonationcenterdoes
OSHAallowforunglovedvenipunctures,providingthephlebotomistisexperiencedandnota
trainee.Thephlebotomistmustagreenottoglove.Theemployermustprovideglovesifthe
phlebotomistwantsthem.Ifthephlebotomistisallergictolatexorpowderedgloves,theemployer
mustprovidehypoallergenicorunpowderedgloves,liners,orbarriercream.Thephlebotomistmust
gloveifherskinisbrokenorburnt,orhasarash.Ifthepatientiscombativeorlikelytohavea
reaction,thenthephlebotomistmustglove.Employersmustreevaluatethenoglovepolicy
periodicallytoseeifitcontinuestobealowriskoption.Whenevercontactwithbloodislikely,such
asduringinfantheelpricks,glovesarerequired.
2.B:Toxicology.Serology/Immunologystudiesantibodiesintheliquidpartofblood.Cytology
studiescellsforcancer,suchasPapsmears.Endocrinologystudieshormones,suchasdiabetesand
acromegaly.
3.C:Normalhemoglobin.HemoglobinelectrophoresisdifferentiateshemoglobinintonormalHbA
andnormalHbA2,orabnormalHbSinsicklecellpatients,orHbCinhemolyticanemiapatients,or
HbFinafetusornewborn.
4.D:Alloftheabove.Doctors,nurses,socialworkers,chiropractors,lawofficers,daycarestaff,
clergy,teachers,andpsychologistsweredeclaredmandatoryreportersin1996.Thismeanstheymust
reportcertainoccurrencesorsuspicionsorallytotheproperauthoritieswithin24hoursandfollowup
withawrittenreportwithin48hours.Forexample,adoctormustreportSTDorTBtoPublicHealth
topreventanepidemic.Caregivershavetherighttoknowthepatient'sdiagnosisifitputsthemat
riskforinfectionorassault.Suspicionofchildabuse,exploitation,orneglectisreportedtoChild
ProtectiveServicesundertheChildAbusePreventionandTreatmentAct(CAPTA).Eachstatehas
anabusehotline.Manystatesrequireanyonewhohasreasonablecausetoreportchildorelderabuse
orfacecivilliability.Youmustknowthelawofthestateinwhichyoupractice.
5.A:Sensitivity.Sensitivity(recallrate)measureshowmanytimesatestproducestruepositive
results,whichindicatespatientsprobablyhaveadisease,comparedwiththegoldstandardtestfor
thatparticularillness.Sensitivityallowsearlydetectionofdiseaseandpreventsepidemics.Divide
thenumberofpatientswhodefinitelyhavethediseaseandtestpositivebythetotalpatientstested
whohavethedisease(includingthosewhotestedfalsenegative),andmultiplyby100toobtainthe
percentagesensitivity.Specificitymeasureshowmanytimesatestproducestruenegativeresults,
meaningpatientsprobablydonothaveadisease,comparedwiththegoldstandardtestforthat
particularillness.Specificityisimportantforcancerchemotherapyandothertoxictreatments.
Aliquotisdividingasolutionintoequalparts.Aliquotallowsveryexpensivereagentsordrugs,and
bloodsamplesthatarebelowscale,tobeusedefficiently.Circadianrhythmisanormaldailyflow
thataffectshormones,whicharenormallyhigherinthemorningthanintheafternoon.

VideoReview
PracticeQuestions
1.OSHAallowsunglovedphlebotomyonlyif:
a.Theexperiencedphlebotomistworkinginavolunteerblooddonorcenteragrees.
b.Thephlebotomist'sskinisintactandthepatientiscooperative.
c.Bothaandb
d.Thepatientisaninfant.
2.Thehospitaldepartmentthatstudiesalcohol,drugs,poisons,andheavymetalsis:
a.Serology/Immunology
b.Toxicology
c.Cytology
d.Endocrinology
3.Ahemoglobinelectrophoresisresultofadulthemoglobin(HbA)orHbA2meansthepatient
has:
a.Sicklecellanemia
b.Fetalhemoglobin
c.Normalhemoglobin
d.Hemolyticanemia
4.USlawoverridesthepatient'srighttoconfidentialityif:
a.Thepatienthasasexuallytransmitteddiseaseortuberculosis(TB)
b.Thecaregiverislikelytobeinfected
c.AuthoritiessuspectchildabuseorneglectunderCAPTA
d.Alloftheabove
5.Therecallrateisalsoknownasthe:
a.Sensitivity
b.Specificity
c.Aliquot
d.Circadianrhythm
AnswerKey

1.C:Bothaandb.TheUSOccupationalSafetyandHealthAdministration(OSHA)setsthe
standardsforproperhandwashing,wearinggloves,baggingspecimensinbiohazardbags,and
disposingofneedlesandlancetsinasharpssafecontainer.Visithttp://www.osha.govregularlyto
findupdates.OSHArequiresphlebotomiststoglovebeforeeveryvenipunctureaspartofstandard
(universal)precautionsforbloodbornepathogens.Onlyinavolunteerblooddonationcenterdoes
OSHAallowforunglovedvenipunctures,providingthephlebotomistisexperiencedandnota
trainee.Thephlebotomistmustagreenottoglove.Theemployermustprovideglovesifthe
phlebotomistwantsthem.Ifthephlebotomistisallergictolatexorpowderedgloves,theemployer
mustprovidehypoallergenicorunpowderedgloves,liners,orbarriercream.Thephlebotomistmust
gloveifherskinisbrokenorburnt,orhasarash.Ifthepatientiscombativeorlikelytohavea
reaction,thenthephlebotomistmustglove.Employersmustreevaluatethenoglovepolicy
periodicallytoseeifitcontinuestobealowriskoption.Whenevercontactwithbloodislikely,such
asduringinfantheelpricks,glovesarerequired.
2.B:Toxicology.Serology/Immunologystudiesantibodiesintheliquidpartofblood.Cytology
studiescellsforcancer,suchasPapsmears.Endocrinologystudieshormones,suchasdiabetesand
acromegaly.
3.C:Normalhemoglobin.HemoglobinelectrophoresisdifferentiateshemoglobinintonormalHbA
andnormalHbA2,orabnormalHbSinsicklecellpatients,orHbCinhemolyticanemiapatients,or
HbFinafetusornewborn.
4.D:Alloftheabove.Doctors,nurses,socialworkers,chiropractors,lawofficers,daycarestaff,
clergy,teachers,andpsychologistsweredeclaredmandatoryreportersin1996.Thismeanstheymust
reportcertainoccurrencesorsuspicionsorallytotheproperauthoritieswithin24hoursandfollowup
withawrittenreportwithin48hours.Forexample,adoctormustreportSTDorTBtoPublicHealth
topreventanepidemic.Caregivershavetherighttoknowthepatient'sdiagnosisifitputsthemat
riskforinfectionorassault.Suspicionofchildabuse,exploitation,orneglectisreportedtoChild
ProtectiveServicesundertheChildAbusePreventionandTreatmentAct(CAPTA).Eachstatehas
anabusehotline.Manystatesrequireanyonewhohasreasonablecausetoreportchildorelderabuse
orfacecivilliability.Youmustknowthelawofthestateinwhichyoupractice.
5.A:Sensitivity.Sensitivity(recallrate)measureshowmanytimesatestproducestruepositive
results,whichindicatespatientsprobablyhaveadisease,comparedwiththegoldstandardtestfor
thatparticularillness.Sensitivityallowsearlydetectionofdiseaseandpreventsepidemics.Divide
thenumberofpatientswhodefinitelyhavethediseaseandtestpositivebythetotalpatientstested
whohavethedisease(includingthosewhotestedfalsenegative),andmultiplyby100toobtainthe
percentagesensitivity.Specificitymeasureshowmanytimesatestproducestruenegativeresults,
meaningpatientsprobablydonothaveadisease,comparedwiththegoldstandardtestforthat
particularillness.Specificityisimportantforcancerchemotherapyandothertoxictreatments.
Aliquotisdividingasolutionintoequalparts.Aliquotallowsveryexpensivereagentsordrugs,and

bloodsamplesthatarebelowscale,tobeusedefficiently.Circadianrhythmisanormaldailyflow
thataffectshormones,whicharenormallyhigherinthemorningthanintheafternoon.
VideoReview